Re-set the Clocks: I-10 Reaction Swift, Decisive

Reaction was swift and decisive among healthcare leaders following yesterday’s announcement from the Department of Health and Human Services (HHS) that its proposed rule would delay required compliance by one year—from October 1, 2013, to October 1, 2014.

“We’re glad the delay is not greater than one year, and we plan to use the new time wisely,” Rudy Braccili, executive director of revenue cycle services for Boca Raton Regional Hospital, told ICD10monitor. “Providers who do so will be well positioned to minimize the financial risk posed by this massive documentation and coding transformation.”

Timing of the announcement

Although the Centers for Medicare & Medicaid Services had said earlier that an announcement of the new deadline would be made in April, some healthcare executives were expecting the announcement to come later in the month. The surprise announcement was not lost on Dennis Winkler, director of technical program management for Blue Cross Blue Shield of Michigan.

“The quick response from the government about the ICD-10 delay decision helps all entities in their planning for the transition,” Winkler said in a statement to ICD10monitor. “With a one-year delay, much of the work remains the same, but it enables people to extend their timelines for internal and external testing as well as giving some entities time to catch up if competing priorities delayed their ICD-10 implementation.”

The timing of the delay was noted by Rose Dunn, former interim president of AHIMA, and chief operating officer for First Class Solutions in Missouri.

“It’s interesting that this delay is announced during an election year,” said Dunn. “Putting that aside, I think there are a number of providers that will benefit from a delay. Personally, I would have preferred six months, because I believe the majority of providers (and payers) have geared up to be ready by October 2013, so the additional six months would have allowed for some additional testing and remediation.”

Echoing that sentiment was Ian C. Bonnet, vice president of WellPoint, who said in a written statement that the extra time would be valuable.

Extra time

“We’re anticipating the extra time will be useful in performing additional testing with external partners,” wrote Bonnet. “And we’re continuing to move forward with much of our original plan including the disciplined translation between ICD-9 and ICD-10 to support our system and rule configuration.”

On the other hand, Dunn said the same goals could have been achieved with a six-month delay, but perhaps would not have been politically palpable.

The politics of change

“A six-month delay could have been accomplished, similar to the penalty grace period that has been used for 5010, but that may not have played out well during at the ballot box,” said Dunn. “My bottom line is that one year is too long and will likely affect the momentum of providers and encourage a wait-and-see attitude toward any of CMS’ initiatives in the future. I’d encourage providers to use this time wisely to continue their preparation at a calmer pace.”

BCBSM’s Winkler added, “Luckily, at Blue Cross Blue Shield of Michigan, we had already started working on our plans for a one-year delay and now we can continue our work towards ICD-10 compliance.”

In a news release issued yesterday, HHS Secretary Kathleen Sebelius stated that the proposed change in the compliance date for ICD-10 would give providers and other covered entities more time to prepare and fully test their systems to ensure a smooth and coordinated transition to these new code sets.

Stop all the clocks

Those who have been using countdown clocks to mark the elapsing days of the earlier compliance deadline of October 2013 will have to re-set their clocks, including the countdown clock on the ICD10monitor home page, which has since been moved ahead.

As noted the 20th-century Anglo-American poet W.H. Auden, “Stop all the clocks, cut off the telephone, Prevent the dog from barking with a juicy bone, Silence the pianos and with muffled drum… ”